What do we mean by recovery (or remission) from an eating disorder?

I’ve noticed many parents avoid the word ‘recovery’ and I wonder if some of the following issues need to be teased out:

Recovery means different things for different people at different times.

We never know what the future may bring. How many tests of fate should our child go through before we know she’s relapse-proof?

We want to show consideration for all the parents whose children still require a lot of care in spite of everyone’s best efforts. We say, ‘Nobody recovers, we’re all in the same boat,’ instead of ‘My kid recovered, yours is having ups and downs; we both did the best we could, and life has treated us differently.’

We also want to show consideration for long-term eating-disorder sufferers who are doing a heroic job of regularly resisting urges to restrict and who relapse every now and again.

If we celebrate victories, if we say, ‘My child had an eating disorder but she’s recovered now,’ are we tempting fate? I see a lot of this among parents, and unless they’re unusually superstitious, I guess this is just a front for some of the other issues here.

We’re hoping to protect ourselves from a big disappointment by setting our sights low. In my experience, climbing heights to celebrate and enjoy the view doesn’t set us up for a fall, but allows us to be fully in the moment. And being in the moment is where we find our power, which will help us deal with bad times if and when they arise.

We fear people will judge us if our child relapses, and we hope to protect ourselves by never sounding too confident.

And the only issue I would pay any attention to: we fear that if we pronounce our child recovered, we will stop being vigilant, and so if our child has a setback we won’t react fast enough.

Is recovery possible? Clinicians may tell you that they have high success rates in treating eating disorders, but this means very little if they don’t define words like ‘success’ or ‘positive outcomes’. Even in the scientific world, where the expression ‘full remission’ is cautiously used in place of ‘recovery’, things are not as you might first expect. You need to read the small print.

In some studies, ‘full remission’ means the ex-patient doesn’t fit particular diagnostic criteria for the illness any more. So someone with anorexia could have achieved ‘full remission’ for five years while taking care to remain slightly below her healthy weight and never allowing herself an ice cream. A person with bulimia might be classed as recovered because she ‘only’ vomits once a month.

These may be very welcome markers of progress, but it’s not what we parents wish for when we talk of recovery.

Sometimes, parents or therapists seem to accept the status quo when perhaps more could be done. I’ve seen thin, pale young women talk publicly about their recovery, urging parents to take heart as there is light at the end of the tunnel. What I’m hearing and seeing is that things are still hard but they’re managing to keep the demon at bay much of the time. I’m upset when they raise money for eating-disorders organisations by running marathons, and I’m upset when they seem unaware of one glaring issue – they need to continue putting on weight. What they call ‘recovery’ seems rather fragile to me. My heart goes out to them because I imagine they are still suffering considerably.

While an eating disorder is taking over your child’s life, it can look like it’s going to stick around for ever. But for many people that’s not the case at all. If you need some hope, there’s a collection of stories on the Around the Dinner Table forum under the heading ‘Road to recovery: Stories of hope’. These are brief accounts from parents whose children are now well.

Note: This section was initially in Chapter 10 my book, which tends to get bigger whenever I revise it, so moving it here is my way of managing everything I want to make available to you!

Caution please (Disclaimer)

I’m a parent – not a clinician. This site is not a substitute for professional advice. Pay attention to your instincts, read widely, speak to other parents, and most importantly, keep your clinicians in the loop.